Paul Burstow, the care services minister, has indicated that he would like to see telehealth and telecare services provided to the NHS without the need for up-front capital payments.

Speaking at the King's Fund international congress on telehealth and telecare, Burstow said a community nurse supervisor should be able to pay for a blood pressure monitor through a monthly contract, in a similar way to that in which people pay for iPhones or Blackberrys.

Such a strategy is already used in Gloucestershire, where the NHS is working with provider Tunstall. The company covers the up-front costs, such as clinical engagement, pathway redesign and training, and supplies NHS Gloucestershire on a per patient per month basis.

"NHS Gloucester avoids the need for large scale up-front costs, and it enables the supplier to build relationships with patients and customers that it otherwise would not have," the minister said.

Burstow also predicted that in time the cost of the telehealth and telecare technologies will start to fall.

"Costs in the UK are significantly higher than they are in the US, and it is no wonder because in the current situation we have only 6,000 users, compared to 10 times that number in the veterans' association in the US," said Burstow. "That is why we are looking at promoting our campaign, 3millionlives, why we want to grow this rapidly."

One of the principal challenges to the large scale take up of telehealth and telecare is broadband capacity, said Burstow, particularly because many of those who stand to benefit from the technologies live in rural areas where broadband provision is worst, although the government has earmarked £530m of funding to improve the situation. There are also issues, according to Burstow, with NHS and social care staff not having sufficient skills and understanding about telehealth and telecare.

To resolve this issue, the government has asked the NHS Institute to develop a support programme for staff and patients so they can make the most of these technologies at a local level.